Bahram Jam webinar Q&A

A physiotherapist with nearly three decades of experience explains how his approach to persistent pain has shifted from a strongly biomechanical model to a more evidence-based, biopsychosocial one. He describes moving away from the idea that manual therapy, manipulation, muscle timing, or structural correction are the main drivers of recovery, and instead emphasizes movement, function, therapeutic alliance, and patient self-management. A major theme is language. He prefers “persistent pain” over “chronic pain” because “chronic” can create hopelessness for both patients and clinicians. He also discusses how imaging findings such as disc degeneration are often overinterpreted, and why education around pain should be gradual and tied to trust rather than confrontation. The discussion highlights placebo as a meaningful neurophysiological effect, not a dismissal of treatment, and explores how clinician beliefs, communication, consent, and motivational interviewing shape outcomes. He argues that physiotherapy should focus less on fixing pain and more on helping people return to valued activities, improve quality of life, and develop a healthier relationship with their symptoms.